Teaching image withheldThe image will be revealed when it becomes clinically available in the case.

$Diagnostic imaging: sagittal CT reconstruction of the lumbar spine demonstrating a flexion-distraction (Chance-type) vertebral fracture pattern; correlate with the seatbelt sign and abdominal pain while evaluating for associated hollow-viscus injury. teaching visual$

Diagnostic imaging: sagittal CT reconstruction of the lumbar spine demonstrating a flexion-distraction (Chance-type) vertebral fracture pattern; correlate with the seatbelt sign and abdominal pain while evaluating for associated hollow-viscus injury. • TEACHING IMAGE

Blunt thoracoabdominal and spinal traumaMotor vehicle collision with forceful forward flexion against a lap-shoulder seatbeltIntermediate

Chance Fracture After Motor Vehicle Collision: Do Not Miss the Bowel Injury

SCENARIO

A 34-year-old restrained driver is brought to the emergency department after a frontal motor vehicle collision. The patient has a prominent transverse abdominal ecchymosis consistent with a seatbelt sign, severe low-back pain, and diffuse abdominal tenderness without peritonitis. Initial airway and circulation are intact. After analgesia and initial resuscitation, vital signs remain adequate for CT. Trauma CT imaging is obtained, including a sagittal lumbar reconstruction. The uploaded CT image is now available for review.

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